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Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024)

Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024): Patient Evaluation for Bariatric Surgery → BMI Assessment (2024) → Obesity-Related Comorbidities...

Interactive Decision Tree

Mini Map

Algorithm Steps

  1. Start

    Patient Evaluation for Bariatric Surgery

    Comprehensive assessment

    1. Decision

      BMI Assessment (2024)

      • BMI ≥35: Eligible regardless of comorbidities
      • BMI 30-34.9: Eligible if metabolic disease
      • BMI <30: Generally not indicated
      1. Decision

        Obesity-Related Comorbidities

        • T2DM, HTN, dyslipidemia
        • OSA, NASH, GERD
        • Obesity hypoventilation
        1. Decision

          Contraindications

          • Active substance abuse
          • Uncontrolled psych illness
          • Unable to comply with follow-up
          1. End

            Not Currently Candidate

            Address contraindications, medical management

          2. Action

            Multidisciplinary Evaluation

            Nutrition, psych, medical optimization

            • Nutritional education
            • Psychological evaluation
            • EGD if indicated
            1. Decision

              Procedure Selection

              • Sleeve: most common, simpler
              • RYGB: GERD, diabetes, higher BMI
              • DS/SADI-S: super-obese, revision
              1. Action

                Sleeve Gastrectomy

                50-60% EWL expected

                1. End

                  Surgical Planning

                  Insurance auth, preop optimization, OR scheduling

              2. Action

                Roux-en-Y Gastric Bypass

                60-70% EWL, best for GERD

              3. Action

                Duodenal Switch/SADI-S

                Highest weight loss, more malabsorption

Guideline Source

ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery 2024

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • 2024 guidelines lowered BMI threshold to 30 with comorbidities
  • Insurance coverage may not align with current guidelines
  • Procedure choice depends on surgeon experience and patient factors

Contraindicated Populations

Active substance abuseUncontrolled psychiatric illness

Applicable Regions

USAUUKEU

AU: OSSANZ bariatric criteria

UK: NICE obesity surgical guidelines

US: ASMBS 2024 guidelines

Version 1Next review: 2028-01-01

Frequently Asked Questions

What is the Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024)?

The Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024) is a diagnostic clinical algorithm for Upper GI Surgery. It provides a structured decision tree to guide clinical decision-making, based on ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery 2024.

What guideline is the Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024) based on?

This algorithm is based on ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery 2024 (DOI: 10.1016/j.soard.2024.01.001).

What are the limitations of the Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024)?

Known limitations include: 2024 guidelines lowered BMI threshold to 30 with comorbidities; Insurance coverage may not align with current guidelines; Procedure choice depends on surgeon experience and patient factors. Individual patient factors may require deviation from these recommendations.

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